Trends in Cerebrovascular Disease Mortality Among Alzheimer Patients in Older Adults Across the USA: A CDC Wonder Analysis.

Abstract

Introduction: Alzheimer's Disease (AD) is the most common form of dementia, affecting more than 55 million individuals worldwide. Cerebrovascular Disease (CeVD) has been shown to co-exist with AD. This study aimed to shed light on this mortality trend to make a positive difference in improving patient care.

Methods: Data were extracted from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database using CeVD as the underlying cause of death, and AD as a multiple cause of death, from 1999 to 2020 for older adults (≥ 65 years). The Age- Adjusted Mortality Rates (AAMRs) were calculated per 100,000 individuals, and trends were assessed using Joinpoint as the Average Annual Percentage Changes (AAPCs).

Results: In total, 64,749 deaths were reported. The overall AAMR declined from 10.21 (1999) to 5.28 (2020). Females had higher AAMRs than males (7.75 vs. 5.59). Non-Hispanic White individuals had the highest AAMR (7.26), while the West region (8.57) and non-metropolitan areas (9.14) showed elevated rates. Vermont (11.81) and Washington (11.56) exhibited the highest death rates, in contrast to Nevada (3.08) and New York (3.25). Most deaths occurred in nursing homes, followed by medical facilities.

Discussion: Mortality declined overall, attributed to advancements in healthcare and prevention, but significant disparities persist among women, non-Hispanic White populations, western, and rural regions. Limitations include potential death certificate misclassification. Future studies should further evaluate targeted interventions, such as community-tailored interventions, to enhance equity.

Conclusion: These trends showed significant spatiotemporal and demographic variation. Targeted interventions are required to mitigate fatalities, particularly in high-risk populations.